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Echocardiography and 64-multislice computed tomography angiography in diagnosing coronary artery fistula

Ping Zhang1, Guoxiang Cai, Jianghua Chen

  • 1Department of Radiology, Teaching Hospital, Fujian medical University, Xiamen, China.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|January 4, 2011
PubMed

Insights

Echocardiography is a useful routine test for diagnosing coronary artery fistula (CAF). 64-multislice computed tomography (64-MSCT) angiography offers superior detail for surgical planning in complex CAF cases.

Area of Science:

  • Cardiovascular Imaging
  • Diagnostic Radiology
  • Congenital Heart Disease

Background:

  • Coronary artery fistulas (CAF) present complex anatomical variations.
  • Accurate pre-operative diagnosis and understanding of adjacent structures are crucial for surgical success.

Purpose of the Study:

  • To evaluate the diagnostic efficacy of echocardiography and 64-multislice computed tomography (64-MSCT) angiography for coronary artery fistulas.
  • To compare the detailed anatomical information provided by each imaging modality for surgical planning.

Main Methods:

  • Retrospective analysis of imaging data from 16 patients with surgically or digital subtraction angiography-confirmed CAF.
  • Echocardiography was performed on all 16 patients.
  • 5 patients underwent 64-MSCT angiography for detailed pre-operative anatomical assessment.

Main Results:

  • Echocardiography correctly diagnosed 12 out of 16 CAF cases.
  • Four cases were initially missed by echocardiography, with one subsequently diagnosed by 64-MSCT.
  • 17 fistulae were identified (one patient had two); 10 originated from the left coronary artery and 7 from the right.
  • Common drainage sites included the right heart (8), pulmonary artery (5), left heart (3), and aorta (1).

Conclusions:

  • Echocardiography serves as an effective routine examination for coronary artery fistula.
  • 64-MSCT angiography provides more comprehensive anatomical and pathological details essential for surgical intervention compared to echocardiography.
Abstract

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